As we approach the 2024 presidential election, healthcare is shaping up to be a pivotal topic for voters. With healthcare spending reaching a staggering $4.5 trillion in 2022—accounting for 17.3% of the U.S. GDP—many Americans are deeply concerned about costs and access to care. The U.S. spends more per person on healthcare than any other developed nation—approximately $13,493—yet struggles with poor health outcomes, inequities, and administrative inefficiencies, as highlighted by the Commonwealth Fund.
Paul Shafer, an assistant professor at Boston University, notes, “The cost of healthcare is always a pocketbook concern for Americans.” Both Vice President Kamala Harris and former President Donald Trump have recently ramped up their focus on healthcare, aiming to address these urgent issues, albeit with differing approaches.
Key Healthcare Issues Heading into 2024
1. Medical Debt Around 20 million Americans face medical debt, totaling $220 billion, according to the Peterson-KFF Health System Tracker. The Consumer Financial Protection Bureau recently announced a plan to remove medical debt from credit reports, funded by the American Rescue Plan. Harris has committed to working with states to alleviate medical debt and prevent future accumulations, while Trump has yet to outline a specific plan.
Data shows that among insured adults, 35% with medical debt didn’t fill a prescription due to cost. Wendell Potter, a former Cigna executive, emphasized that high out-of-pocket costs create significant barriers to care, even for those with insurance.
2. High Out-of-Pocket Costs In 2024, the average annual premium for single coverage is $1,368, while family coverage averages $6,296. Many workers face high deductibles—averaging $1,787 for individuals—before insurance kicks in. Trump previously signed an executive order mandating price transparency in hospitals, but high costs remain a concern.
A recent survey revealed that 55% of adults aged 19-64 did not challenge potentially erroneous medical bills, demonstrating the complexities and frustrations surrounding healthcare billing.
3. The Affordable Care Act (ACA) Trump has long pledged to repeal and replace the ACA, though previous attempts have faltered. In contrast, Harris aims to extend enhanced ACA subsidies, which have already helped many Americans save significantly on premiums. Experts argue that ensuring these subsidies continue is critical to maintaining affordable healthcare coverage.
4. Medicaid Expansion Since the ACA’s implementation, states have had the option to expand Medicaid, leaving about 2 million individuals without coverage in the 10 states that haven’t adopted the expansion. Studies show that states that expanded Medicaid have seen reduced uninsured rates and improved racial and ethnic equity in healthcare access.
5. Abortion Rights Reproductive health remains a top issue for many voters. Harris is committed to restoring Roe v. Wade and preventing a national abortion ban. In contrast, Trump’s administration previously took steps to restrict abortion access but is now navigating a more nuanced position. He has expressed support for state-level decisions on abortion while opposing some measures that would codify abortion rights.
Conclusion
As healthcare continues to dominate conversations in the lead-up to the election, voters are keenly aware of the stakes. With both candidates offering contrasting visions for the future of healthcare in America, the choices made at the ballot box could have profound implications for millions of Americans.
